Hello, I am Lee Yoon-jung, the director of the Skin Health Design Clinic in Mapo, Gongdeok. This time, we will discuss all the curiosities about flat warts, which are very common but often not well recognized or discovered, along with my staff. Sometimes, you might feel something bumpy on your face, and it can be confusing whether it's a pimple or something else. There are also cases where you might think it's a pimple, but it strangely keeps spreading. If you notice small brown or skin-colored spots that are gradually spreading, you might want to suspect flat warts. I've heard of regular warts, but I don't think I've heard much about flat warts. What exactly are flat warts? Many people find the term flat warts unfamiliar because when we usually think of warts, we picture them on the hands or the soles of the feet.

You might think of large, bumpy warts that form in the same area, but there are also much smaller, flatter warts. If you look closely at the faces or necks of those around you, you'll find that many people actually have flat warts. Oh, doctor, could it be that I have flat warts too? Yes, that's possible. There are surprisingly many people with flat warts, but they usually don't realize it. Especially when there are only a few, they may not notice them at all until the number starts to increase. However, by that time, they are often already quite widespread. The bigger issue is that even if they notice them, many people don't take it seriously because they don't have any significant discomfort, so they leave them untreated. I think if I didn't feel any discomfort in my daily life, I would probably just leave them alone too. Why is that?

Warts occur due to an infection with the human papillomavirus (HPV). When the virus enters the outer layer of the skin, known as the epidermis, it causes excessive production of keratin and draws nearby capillaries for nutrients, leading to proliferation. Flat warts are similar in that they are caused by a different type of the papillomavirus, which creates new flat-shaped keratin on the skin. The virus is indeed frightening. When a flat wart appears on the face, are there specific ways to distinguish it from other conditions? Initially, we differentiate based on the shape that has developed. Generally, if there are small, brown or skin-colored spots about 1 to 2 mm in diameter, we can suspect they are flat warts. Of course, there are cases where they are larger, and just by looking...

If you touch a spot like that with your hand, you'll feel that it's slightly raised compared to the surrounding skin. If the number of spots gradually increases or suddenly spikes one day, you can be more certain that it’s a wart. We can categorize them based on shape, color, and quantity. However, if flat warts appear in places that are not visible, you might not notice them. Is there any other symptom aside from visible ones? 

Not really. However, sometimes flat warts can appear like red bumps and spread rapidly, which is a sign of active warts. In those cases, many people experience itching. Besides these red bumps, the general brown spots, which are flat warts, can also occasionally itch. Usually, that’s when they start to itch.

It tends to spread well when scratched. Rather, if you don't realize it and scratch it, it could spread everywhere. Then, it seems that this needs to be treated as soon as possible. I thought that if it just appears like a spot and doesn't bother me, I might not need treatment. However, you really need to get treated. In fact, many people ask whether it is absolutely necessary to treat this. Patients who are being treated for atopic dermatitis or other types of eczema often discover flat warts on their bodies. I inform them that they have flat warts. Then, almost all of the patients ask if they really need to get treated. But as I mentioned earlier, flat warts are a condition caused by a viral infection. If left untreated, the virus can spread around and proliferate whenever the immune system is weakened.

You mentioned that viruses spread when immunity is weakened. In what situations does immunity weaken? For example, when a person experiences a lot of stress, lacks sleep, or is excessively fatigued, their immunity can weaken. In such cases, viruses can spread around at any time. The problem is that close contacts, such as family members, can become infected. Warts particularly thrive in humid environments, so sharing wet towels or taking baths together can lead to transmission. While many people have their flat warts removed for cosmetic reasons, it is essential to treat them as they are a viral infection. Even after completely treating flat warts, they can recur. Why does that happen? Yes, it is true that flat warts often reappear even after removal procedures.

The reason for the high recurrence rate is the virus that I have been continuously mentioning. Because of the virus, keratin is formed on the skin in the desert. If we only remove the visible result, which is the keratin, as long as the virus is active inside the skin, it is natural that the keratin can reappear. Treatments mainly focus on laser procedures or occasionally topical applications, but these are all methods aimed at removing keratin. Therefore, it is common for keratin to reappear after treatment, and flat warts to recur. So, wouldn't it be enough to remove the virus? Many people might wonder why the virus is not being eliminated. However, the truth is that there is currently no medication that can completely kill the virus in the desert. While bacteria can be killed with antibiotics, viruses cannot be destroyed or killed by the virus itself.

There is no other way. Therefore, the best way to overcome the virus currently is to boost my immune system. While eliminating the causes, treatment that can enhance immunity to fight and win against the virus must be conducted simultaneously. It seems we need to focus on treatments that boost immunity. What kind of treatments are done to enhance immunity? Since each person has different constitutions and weaknesses, it is essential to assess their condition through direct consultations, but generally, there are treatments such as herbal medicine, moxibustion, and acupuncture. Aside from treatments, what are some ways to boost immunity at home? In fact, the ways to enhance immunity are things that everyone knows. It's important to sleep well, maintain a healthy diet, and, of course, while it's best not to experience stress, if you do encounter stress, it's essential to have your own methods to relieve it.

It is necessary, and it is also good to do light exercises like walking. I feel like I learned a lot about warts today. Lastly, please share a final thought. Yes, please observe your skin condition carefully, and if you suspect any signs of warts, be sure to consult with a medical professional for prompt treatment. This has been Lee Yoon-jung, the director of the Skin Health Design Clinic in Mapo Gongdeok.

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